Esophageal Function Tests are Not Associated with Barium Swallow Findings in Advanced Lung Disease

Posner, Shai; Mehta, Kurren; Parish, Alice; Niedzwiecki, Donna; Gupta, Rajan T.; Fisher, Deborah A.; Leiman, David A.

doi:10.1007/s00455-020-10113-2

Cited by 6 publications

(3 citation statements)

References 33 publications

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“…Specifically, a significant proportion of centers reported BE as the preferred modality of esophageal assessment, likely due to availability and ease of testing. However, the utility of studies such as BE, EGD, and GES in lung transplantation remains questioned, given their suboptimal sensitivity and specificity for GERD diagnosis ( 15 ). Oropharyngeal assessment with modalities such as modified barium swallow may also be considered, although clinical data in this population are similarly limited.…”

Section: Discussionmentioning

confidence: 99%

Esophageal Function and Reflux Evaluations in Lung Transplantation: A Nationwide Survey of UNOS Accredited Transplant Centers in the US

Leung,

Lo,

Sharma

et al. 2023

Clin Transl Gastroenterol

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Background: Gastroesophageal reflux disease has been associated with worse lung transplant outcomes. We aimed to assess local practices for esophageal function testing (EFT) across transplant centers. Methods: Survey study of all UNOS-accredited adult lung transplant centers regarding local EFT practice. Results: Among 39/63 (60%) responded centers, 38.5% required any EFT (35.9% esophageal manometry, 15.4% pH-monitoring, and 28.2% pH-impedance), while another 28.2% may consider EFT based on symptoms. Five-year transplant volume was higher among centers requiring EFT (253 vs 159, p=0.04). Conclusion: Only a minority of lung transplant centers routinely obtained EFT, supporting the need for guidelines for standardized reflux/esophageal assessment.

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Section: Discussionmentioning

confidence: 99%

Esophageal Function and Reflux Evaluations in Lung Transplantation: A Nationwide Survey of UNOS Accredited Transplant Centers in the US

Leung,

Lo,

Sharma

et al. 2023

Clin Transl Gastroenterol

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“…Because the symptoms are intermittent and are vulnerable to dietary and emotional factors, they are often ignored (10).…”

Section: Discussionmentioning

confidence: 99%

Imaging characteristics of esophageal cancer in multi-slice spiral CT and barium meal radiography and their early diagnostic value

Wang¹,

Tang²,

Lin³

et al. 2022

J Gastrointest Oncol

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Background: To explore the imaging characteristics of esophageal cancer in multi-slice spiral CT (MSCT) and barium meal radiography and to analyze the value of the two examinations alone or in combination for cancer staging diagnosis. Methods:The clinical data of 87 patients with esophageal cancer admitted to our hospital from June 2018 to June 2020 were retrospectively analyzed. According to the different examination methods, they were divided into a barium meal group (n=28 cases, X-ray barium meal radiography), an MSCT group (n=29 cases, MSCT examination), and a combined group (n=30 cases, barium meal + MSCT). The imaging characteristics from the barium meal radiography and MSCT alone versus their combined results were compared with the pathological examination results to analyze their accuracy in diagnosing esophageal cancer staging.Results: Of the 87 cases, the esophageal cancer lesion sites were as follows: 23 cervical cases, 20 upper thoracic cases, 21 middle thoracic cases, and 23 lower thoracic cases. The X-ray barium meal examination of esophageal mucosa showed irregular filling of the esophagus. The esophageal wall was stiff or jagged, the lumen was narrow, and it was difficult for the barium to pass, the mucosa was discontinuous. The CT scan showed irregular thickening of the esophageal wall, eccentric and concentric stenosis of the esophageal cavity, and the upper part of the esophagus showed different degrees of expansion. The trachea and bronchi were invaded, deformed, and displaced under compression. The diagnostic staging results of the barium meal group and MSCT group were inconsistent with the pathological results (Kappa =0.105, 0.112; P>0.05). The diagnostic staging results of the combined group were in good agreement with the pathological results (Kappa =0.769). In addition, the accuracy of the combined group in the diagnosis of stage III-IV esophageal cancer among the three groups was significantly higher than that of the barium meal group and MSCT group alone (P<0.05).Conclusions: MSCT and barium meal radiography clearly display the imaging features of esophageal cancer and can provide reliable imaging evidence for preoperative diagnosis; the combination of both measures can effectively improve the accuracy of early diagnosis for esophageal cancer.

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“…Since typical esophageal symptoms are often absent among chronic lung disease patients with EER, objective evidence is needed for diagnosis of GERD. Findings on imaging studies such as barium esophagram do not correlate with reflux monitoring results www.co-gastroenterology.com and are not adequate in establishing or excluding GERD in patients with advanced lung diseases [56]. Upper endoscopy is often used to assess for mucosal abnormalities and complications of chronic GERD, although nonerosive reflux disease is common [44].…”

Section: Diagnostic Approachmentioning

confidence: 99%

Update on extraesophageal manifestations of gastroesophageal reflux

Fernandez,

Chan

2024

Current Opinion in Gastroenterology

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Purpose of Review Symptoms/complications related to extraesophageal reflux (EER) are increasingly prevalent presentations and pose significant challenges for clinicians. We summarize and discuss clinical advances and developments in pathophysiology, testing and treatment algorithms of upper/lower airway manifestations of EER. Recent Findings Growing evidence supports likely multifactorial causes of laryngeal symptoms, including EER, oropharyngeal pathologies, allergic conditions, and cognitive-affective processes (brain-larynx interaction). Diagnostic paradigm for laryngopharyngeal reflux (LPR) is shifting towards a personalized approach with noninvasive strategies/prediction tools to risk-stratify patients for upfront reflux testing over empiric acid suppression trials. Management should be multipronged to include antireflux therapies and treatments targeting other causes. Lower airway complications of EER may result in lung dysfunction and poor transplant outcomes. Esophageal symptoms are often absent and routine esophageal/reflux testing to guide timely antireflux therapies may lead to improved outcomes. Modalities that leverage impedance technology may be important, given the potential role of nonacidic reflux. Novel impedance-based metrics such as mean nocturnal baseline impedance and postreflux swallow-induced peristaltic wave index may provide adjunctive diagnostic values. Summary Standardized approach to diagnosis/management of EER should include multidisciplinary care teams and consider different phenotypes, nonreflux contributors, and the complex gut-airway relationships. Prompt antireflux therapies after careful candidate selection may improve outcomes of these airway complications.

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Esophageal Function Tests are Not Associated with Barium Swallow Findings in Advanced Lung Disease

Cited by 6 publications

References 33 publications

Esophageal Function and Reflux Evaluations in Lung Transplantation: A Nationwide Survey of UNOS Accredited Transplant Centers in the US

Esophageal Function and Reflux Evaluations in Lung Transplantation: A Nationwide Survey of UNOS Accredited Transplant Centers in the US

Imaging characteristics of esophageal cancer in multi-slice spiral CT and barium meal radiography and their early diagnostic value

Update on extraesophageal manifestations of gastroesophageal reflux

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